Quality Improvement

All
issuers offering QHPs through the Exchanges that meet the Quality Improvement
Strategy (QIS) participation criteria must comply with the QIS requirements as
a condition of certification and participation in the Exchanges. CMS annually
publishes the QIS Technical Guidance and User Guide, a detailed guide to the
QIS requirements, and the QIS Implementation Plan and Progress Report Form,
which is the QIS reporting tool for issuers applying for QHP certification.

In
April 2020, CMS released the COVID-19 Marketplace
Quality Initiatives Memo to announce that CMS suspended activities related to the
collection and reporting of clinical quality measure information related to QIS
submissions. In line with this guidance, issuers applying for QHP certification
in the Exchanges for the 2021 plan year that meet the applicable QIS
participation criteria are not expected
to submit a QIS Implementation Plan and Progress Report Form during the 2021
QHP Application Submission and Review Period.

CMS anticipates issuing additional guidance via the Marketplace
Quality Initiatives website for issuers required to submit QIS
forms for plan year 2022 in the fall of calendar year 2020.

Plan Year 2021 QIS Issuer List

The Draft QIS Issuer List for the
2021 Plan Year (2021 QIS Issuer List) is being made available for issuers to
download from the Marketplace Quality Initiatives website. The Draft Plan Year 2021 QIS Issuer List includes
issuers that meet the QIS participation criteria and would have, under normal
circumstances, been required to submit at least one QIS Implementation Plan and
Progress form as part of their 2021 QHP Applications to either: (a) implement a
new QIS beginning no later than January 2021, or (b) provide a progress update
on an existing QIS. The 2021 Draft QIS Issuer List includes issuers operating in
Federally-facilitated Exchanges (FFEs) and FFEs where states perform plan management.
Issuers operating in State-based Exchanges (SBEs), including SBEs on the Federal
Platform (SBE-FPs), are not included on the list.

Although issuers on this list are
not expected to submit data, issuers should still review the data it contains
to verify its accuracy as the Plan Year 2021 Issuer List will be used to inform
the Plan Year 2022 QIS Issuer List.

Issuers should submit questions
about the Plan Year 2021 Draft QIS Issuer List to the Marketplace Service Desk
(MSD) by phone at 1-855-CMS-1515 or by email at
CMS_FEPS@cms.hhs.gov. When submitting inquiries via email, please include
“MQI-QIS Issuer List” and your HIOS Issuer ID in the subject line or body of
the email.